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Do You Know... Methadone

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Do You Know... Street names: juice, meth (also used to refer to methamphetamines) What is it? Methadone belongs to the opioid family of Methadone drugs. It is used most commonly to treat addiction to other opioid drugs such as heroin, oxycodone (e.g., Percodan, Percocet), fentanyl (e.g., Duragesic, Sublimaze) and hydromorphone (e.g., Dilaudid). Methadone is a synthetic opioid, which means that it is made from chemicals in a lab. Methadone was developed in Germany during the Second World War and was first used to provide pain relief. Methadone maintenance treatment, which prevents opioid withdrawal and reduces or eliminates drug cravings, was first developed in the 1960s. For many years, Canadian reg- ulations around the prescription of methadone were so restrictive that few doctors offered the treatment. People who wanted methadone treatment often had to wait months or years. 1/4 © 2003, 2011, 2012 CAMH | www.camh.ca In the 1990s, the need to reduce the harm of drug use with medical care, improves the chances of having a was more clearly recognized, and changes were made healthy baby. There are no known long-term effects of to make it easier for doctors to provide methadone methadone on the baby. treatment. People who inject opioid drugs regularly, and who are Methadone maintenance is not a “cure”: it is a treatment. HIV- or hepatitis C–positive, are enrolled in methadone Through treatment, people who are addicted to opioids treatment to help protect their health. Methadone receive the medical and social support they need to treatment also helps to prevent these infections from stabilize and improve their lives. They are encouraged spreading to others through needle sharing. to stay in treatment for as long as it helps them. The number of people receiving methadone maintenance Another treatment for opioid addiction, buprenorphine/ treatment in Ontario has increased sharply in recent naloxone (Subutex, Suboxone), was approved for use in years, from 6,000 in 2000 to 38,000 in 2012. Canada in 2008. How does methadone make you feel? What does methadone look like? When people begin methadone treatment, some may Pure methadone is a white crystalline powder. For the experience sedation and other effects that are common treatment of addiction, the powder is dissolved, usually to all opioid drugs. As treatment continues and a stable in a fruit-flavoured drink, and is taken orally once a day. dose of methadone is established, tolerance to most of Methadone is also available as a tablet or oral solution these effects develops. Those in treatment often describe for the treatment of severe pain. the feeling of being on methadone as “normal.” Methadone treatment does not interfere with their thinking. They can Who uses methadone? work, go to school or care for family. Methadone also Most people who are prescribed methadone are being blocks the euphoric effect of heroin and other opioids, treated for addiction to opioid drugs. This includes people and in this way reduces the use of these drugs. who are addicted to illegal opioids, such as heroin, and also prescription opioids, such as oxycodone, fentanyl Most people experience some side-effects from and hydromorphone. methadone treatment. Possible side-effects include sweating, constipation and weight gain. Methadone is also sometimes prescribed to provide pain relief for people who have severe chronic pain or pain How long does the effect last? associated with terminal illness. A person who is physically dependent on opioids is kept free of withdrawal symptoms for 24 hours with a single Methadone is sometimes used as a street drug, but when dose of methadone. In contrast, a person who uses heroin it is, it is usually to prevent symptoms of withdrawal from or other short-acting opioids to avoid withdrawal must other opioid drugs. use three to four times a day. Women who use opioid drugs regularly and who are Daily treatment with methadone may continue indefinitely. pregnant are often treated with methadone to protect If, however, the person taking methadone and his or her the fetus. Short-acting opioids such as heroin or hydro- doctor agree to move toward ending treatment, the morphone must be taken frequently to avoid withdrawal. methadone dose is tapered down gradually over many Opioid withdrawal increases the risk of miscarriage or weeks or months, easing the process of withdrawal. premature birth. Methadone maintenance, combined 2/4 | © 2003, 2011, 2012 CAMH | www.camh.ca If methadone is stopped abruptly, symptoms such as What are the long-term effects of methadone? stomach cramps, diarrhea and muscle and bone ache Methadone maintenance is a long-term treatment. Length will occur. These symptoms begin within one to three of treatment varies, from a year or two to 20 years or more. days after the last dose, peak at three to five days and then This prolonged treatment with proper doses of methadone gradually subside, although other symptoms such as sleep is medically safe and is one of the most effective problems and drug cravings may continue for months. treatments currently available for opioid addiction. Is methadone dangerous? When methadone is taken as prescribed, it is very safe and will not cause any damage to internal organs or thinking, even when taken daily for many years. On the other hand, methadone is a powerful drug and can be extremely dangerous to people who are not tolerant to its effects. Even a small amount may be fatal for a child. For this reason, the dispensing of methadone is carefully monitored and controlled. Is methadone addictive? Modern definitions of addiction look at many factors in assessing a person’s drug use. These include tolerance, or the need to use increasing amounts to achieve the same effect; physical dependence, resulting in withdrawal symptoms if drug use is stopped; and compulsive use, despite the negative consequences of continuing to use the drug. Some people say that methadone is just as addictive as heroin. People in methadone treatment do become tolerant to certain effects of the drug, and will experience withdrawal if they do not take their regular dose. But methadone fails to meet a full definition of addictive when we look at how and why the drug is used. First of all, methadone maintenance is offered as a medical treatment, and is prescribed only to people who are already addicted to opioid drugs. For these people, methadone provides a safe alternative to the routine danger and desperation of securing a steady supply of opioid drugs illegally. It frees them from the nagging compulsion to use, and allows them a chance to focus on improving their lives. 3/4 | © 2003, 2011, 2012 CAMH | www.camh.ca One in a series... Alcohol GHB Alcohol, Other Drugs Hallucinogens and Driving Heroin Amphetamines Inhalants Anabolic Steroids Ketamine Benzodiazepines LSD Caffeine Methadone Cannabis Methamphetamine Cocaine Prescription Opioids Ecstasy Tobacco For more information on addiction and mental health issues, or to download a copy of this brochure, please visit our website: www.camh.ca This publication may be available in other formats. For information about alternative formats, to order multiple copies of this brochure, or to order other CAMH publications, please contact Sales and Distribution: Toll-free: 1 800 661-1111 Toronto: 416 595-6059 E-mail: [email protected] Online store: http://store.camh.ca To make a donation, please contact the CAMH Foundation: Tel.: 416 979-6909 E-mail: [email protected] If you have questions, concerns or compliments about services at CAMH, please contact the Client Relations Service: Tel.: 416 535-8501 ext. 32028 or 32027 Copyright © 2003, 2011, 2012 Centre for Addiction and Mental Health A Pan American Health Organization / World Health Organization Collaborating Centre Fully affiliated with the University of Toronto Disponible en français. 4274mb/02-2013 / P270 4/4 | © 2003, 2011, 2012 CAMH | www.camh.ca.
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